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TORRENTE ET AL.<br />
Only a handful of randomized control trials conducted in low-income and<br />
conflict-affected countries have shown promise in addressing children’s psychosocial<br />
and mental health needs through school-based programs. The three studies most<br />
relevant to this paper were conducted in conflict-affected regions of Nepal, Indonesia,<br />
and Sri Lanka, where authors found mixed results from a secondary prevention<br />
program involving trauma-processing activities, cooperative play, creative expression,<br />
and cognitive behavioral therapy. The Nepali evaluation used a sample of eight schools<br />
and did not find significant main effects, but it did find beneficial effects for subgroups<br />
of children in terms of psychological difficulties, aggression, prosocial behavior, and<br />
sense of hope (Jordans et al. 2010). The Indonesian trial, in which fourteen schools were<br />
randomized to treatment versus control conditions, found positive effects on children’s<br />
PTSD symptoms and sense of hope, but not on stress-related physical symptoms,<br />
depression, anxiety, or functional impairment (Tol et al. 2008). Similar results were<br />
found in a cluster-randomized trial of a comparable program in Sri Lanka. In that case,<br />
however, harmful effects were found for girls’ PTSD symptoms (Tol et al. 2012).<br />
In spite of emerging research, the current body of evidence on effective<br />
practices to promote mental health in low-income and conflict-affected contexts<br />
remains limited and inconclusive. Moreover, no studies have been conducted that<br />
test the potentially positive impact of universal programs that have a combined<br />
focus on student well-being and academic curricula. School-based programs to<br />
improve mental health that are fully integrated with the academic curricula are<br />
more likely to be scalable and sustainable, particularly in resource-constrained<br />
settings. This paper examines the impacts of one such integrated program on<br />
Congolese children’s mental health outcomes.<br />
54<br />
Journal on Education in Emergencies